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Diagnosis of primary esophageal synovial sarcoma by demonstration of t(X;18) translocation: a case report

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Synovial sarcoma (SS) is an uncommon soft tissue tumor occurring mainly in the periarticular region of the extremities of young adults. In this report, we describe a very rare occurrence of primary SS of the esophagus in a 72-year-old woman. Histologically, the tumor demonstrated biphasic morphologic findings associated with poorly differentiated areas. Tumor cells expressed vimentin, epithelial (EMA, CK7, AE1/3), bcl-2 and neuroectodermal (CD56, CD57, CD99) antigens. Differential diagnose included esophageal sarcomatoid carcinoma. Cytogenetic analysis confirmed the diagnosis of SS by identifying t(X;18) translocation. The literature of this very uncommon entity of the esophagus is reviewed.

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  1. Amr SS, Shihabi NK, Al Hajj H (1984) Synovial sarcoma of the esophagus. Am J Otolaryngol 5:266–269

    Article  PubMed  CAS  Google Scholar 

  2. Anton-Pacheco J, Cano I, Cuadros J, Vilarino A, Berchi F (1996) Synovial sarcoma of the esophagus. J Pediatr Surg 31:1703–1705

    Article  PubMed  CAS  Google Scholar 

  3. Billings SD, Meisner LF, Cummings OW, Tjada E (2000) Synovial sarcoma of the upper digestive tract : a report of two cases with demonstration of the X;18 translocation by fluorescence in situ hybridization. Mod Pathol 13:68–76

    Article  PubMed  CAS  Google Scholar 

  4. Bloch MJ, Iozzo RV, Edmunds LH Jr, Brooks JJ (1987) Polypoid synovial sarcoma of the esophagus. Gastroenterology 92:229–233

    PubMed  CAS  Google Scholar 

  5. Bonavina L, Fociani P, Asnaghi D, Ferrero S (1998) Synovial sarcoma of the esophagus simulating achalasia. Dis Esophagus 11:268–271

    PubMed  CAS  Google Scholar 

  6. Fisher C (1998) Synovial sarcoma. Ann Diagn Pathol 2:401–421

    Article  PubMed  CAS  Google Scholar 

  7. Habu S, Okamoto E, Toyosaka A, Nakai Y, Takeuchi M (1998) Synovial sarcoma of the esophagus: report of a case. Surg Today 28:401–404

    Article  PubMed  CAS  Google Scholar 

  8. Hamilton SR, Aaltonen LA (eds) (2000) World Health Organization classification of tumours of the digestive system. IARC, Lyon

  9. Hasegawa T, Yamamoto S, Nojima T, Hirose T, Nikaido T, Yamashiro K, Matsuno Y (2002) Validity and reproducibility of histologic diagnosis and grading for adult soft-tissue sarcomas. Hum Pathol 33:111–115

    Article  PubMed  Google Scholar 

  10. Kawauchi S, Kukuda T, Oda Y, Saito T, Olga A, Takeshita M, Yokohama K, Chuman H, Iwamoto Y, sasaki K, Tsuneyoshi M (2000) Prognostic significance of apoptosis in synovial sarcoma: correlation with clinicopathologic parameters, cell proliferative activity, and expression of apoptosis-related proteins. Mod Pathol 13:755–765

    Article  PubMed  CAS  Google Scholar 

  11. Kwon MS, Hong SJ, Cho HA, Ahn GH, Lee SS, Lee KY, Rhyu MG (2003) Extensive and divergent chromosomal losses in squamous and spindle-cell components of esophageal sarcomatoid carcinoma. Virchows Arch 443:635–642

    Article  PubMed  Google Scholar 

  12. Limon J, Dal Cin P, Sandberg AA (1986) Application of long-term collagenase disaggregation for the cytogenetic analysis of human solid tumors. Cancer Genet Cytogenet 23:305–313

    Article  PubMed  CAS  Google Scholar 

  13. Matsumoto T, Fujii H, Arakawa A, Yamasaki S, Sonoue H, Hattori K, Kajiyama Y, Hirose S, Tsurumaru M (2004) Loss of heterozygosity analysis shows monoclonal evolution with frequent genetic progression and divergence in esophageal carcinosarcoma. Hum Pathol 35:322–327

    Article  PubMed  CAS  Google Scholar 

  14. Mitelman F (ed) (1995) ISCN: an international system for human cytogenetic nomenclature. Karger, Basel

  15. Nilsson G, Skytting B, Xie Y, Brodin B, Perfekt R, Mandahl N, Lundeberg J, Uhlen M, Larsson O (1999) The SYT-SSX1 variant of synovial sarcoma is associated with a high rate of tumor cell proliferation and poor clinical outcome. Cancer Res 59:3180–3184

    PubMed  CAS  Google Scholar 

  16. Ohtaka M, Kumasaka T, Nobukawa B, Hirai S, Suda K, Ohno Y, Iwasaki R, Ikegami Y, Fukasawa M (2002) Carcinosarcoma of the esophagus characterized by myoepithelial and ductal differentiations. Pathol Int 52:657–663

    Article  PubMed  Google Scholar 

  17. Palmer Bv, Levene A, Shaw HJ (1983) Synovial sarcoma of the pharynx and esophagus. J Laryngol Otol 97:1173–1176

    Article  PubMed  CAS  Google Scholar 

  18. Perch SJ, Soffen EM, Whittington R, Brooks JJ (1991) Esophageal sarcomas. Surg Oncol 48:194–198

    Article  CAS  Google Scholar 

  19. Rosen G, Forsher C, Lowenbraun S, Eilber F, Eckardt J, Holmes C, Fu YS (1993) Synovial sarcoma. A study of intensive chemotherapy in 14 patients with localized disease. Cancer 73:2506–2511

    Article  Google Scholar 

  20. Trassard M, Le Doussal V, Hacene K, Terrier P, Ranchere D, Guillou L, Fiche M, Collin F, Vilain MO, Bertrand G, Jacquemier J, Sastre-Garau X, Bui NB, Bonichon F, Coindre JM (2001) Prognostic factors in localized primary synovial sarcoma: a multicenter study of 128 adult patients. J Clin Oncol 19:525–534

    PubMed  CAS  Google Scholar 

  21. Weiss SW, Goldblum JR (2001) Malignant soft tissue tumors of uncertain type. In: Weiss SW, Goldblum JR (eds) Enzinger and Weiss’s soft tissue tumors, 4th edn. Mosby, St Louis, MO, pp 1483–1571

    Google Scholar 

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We are grateful to Elodie Basc and Mireille Mari for skilful technical assistance. This work was supported by the Programme Hospitalier de Recherche Clinique National 2003 du CHU de Nice, The Ligue Nationale Contre le Cancer, Comité des Alpes-Maritime and the Cancéropôle Provence Alpes-Côte d’Azur.

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Correspondence to Paul Hofman.

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Butori, C., Hofman, V., Attias, R. et al. Diagnosis of primary esophageal synovial sarcoma by demonstration of t(X;18) translocation: a case report. Virchows Arch 449, 262–267 (2006).

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